Tuesday, May 27, 2008

Hillary Clinton has a national healthcare plan. Barack Obama has a healthcare plan, too, although his is somewhat less comprehensive than Hillary’s. John McCain has no plan, save for one to keep the U.S. Military engaged in Middle East affairs for as long as it takes to defeat global terrorism—a mammoth undertaking with a high probability of failure, given the climate of violence arising out of ongoing clashes of ideologies. But, I digress; McCain and global terrorism are not part of this discussion.

No, this discussion is about devising an affordable healthcare plan that’s inclusive of all Americans. While both the Clinton and Obama plans are better than the current one, neither of them goes the full distance. Each relies on a mish-mash of obsolete ideas and outdated methodology to achieve less-than-perfect results.

Although most everyone agrees that the healthcare system needs an overhaul, few agree on how to do it. Granted, it’s a complex subject not given to quick or easy fixes, so maybe it’s better to drop the notion of an overhaul and begin thinking in terms of designing a new system from the ground up.

The first consideration in devising a new healthcare plan is trimming costs without paring away essential services. Make every healthcare dollar count by adopting more efficient methods, eliminating wasteful spending, and by taking advantage of numerous medical and medicinal alternatives.

A single-payer system seems like the best option for providing broad-spectrum healthcare coverage to all citizens at the lowest possible cost. Private and group health insurance carriers need to make a profit in order to survive, and every dollar that goes toward insurance company profits is a dollar not spent directly on medical services. At least 30% of the money now spent on healthcare insurance is essentially wasted because it disappears into the black hole of insurance company profits.

Prevention is almost always cheaper than the cure, but vast sums of money are wasted because preventive medicine is often disallowed, thereby assuring that preventable or easily cured illnesses evolve into ailments that are both more difficult and more expensive to treat. Could annual health checkups for everyone ultimately result in lower healthcare costs due to early detection and treatment of potentially life-threatening or life-changing illnesses?

The uninsured also contribute to rising medical costs because they tend to delay seeking treatment until an ailment becomes life-threatening, at which point they enter the healthcare system through a hospital emergency ward, where medical costs are among the highest, but where, by law, treatment can’t be refused because of an inability to pay.

Over-reliance on prescription drugs is another factor in rising medical care costs. Natural remedies are sometimes as effective as their Big Pharma-supplied counterparts, and they’re almost always less expensive. Unfortunately, lower-cost alternatives are either ignored or banned outright while high-priced pharmaceuticals drive healthcare costs ever higher.

Personal choices also affect the cost of health care. Emphasize health education by making health studies a mandatory part of the school curriculum at every grade level. An increase of health awareness will surely lead to better diets and nutrition, optimal physical fitness, and smarter lifestyle choices, all of which have the potential to extend life expectancy while lowering overall healthcare costs. Personal responsibility for one’s health is not something that can or should be left out of the healthcare equation.

Financing and administering a universal healthcare plan pose the greatest challenges to providing comprehensive care to everyone. To simplify things, why not roll universal health care under the Social Security umbrella? Create a new healthcare fund to co-exist side-by-side with the Social Security retirement fund (but in a separate account), with both employers and employees paying into it, just as they now pay into the Social Security fund. Employers and employees alike will pay substantially less to a single-payer insurer than they now pay to group insurers, and get a better level of healthcare in the bargain.

The foregoing ideas are preliminary, basic, and intended only to provide the barest framework around which to build a viable, comprehensive healthcare plan that works for everyone. No doubt that much work remains to be done. Others will have different ideas, perhaps better ideas, but all ideas must be considered until such time that our political leaders, grassroots activists, and citizen voters pool their collective resources to devise and implement a workable healthcare package that leaves no citizen behind.